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NPI Code Detail

MEDICARE: JESSICA ESMERALDA GAYTAN

MEDICARE: JESSICA ESMERALDA GAYTAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1447736673
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA ESMERALDA GAYTAN
Provider Business Mailing Address
First Line : 3517 CAMINO DEL RIO S STE 407
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4028
Country : US
Telephone Number : 619-955-8905
Fax Number :
Provider Business Practice Location Address
First Line : 3517 CAMINO DEL RIO S STE 407
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4028
Country : US
Telephone Number : 619-955-8905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2018
Last Update Date : 02/01/2021

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Directions to “ JESSICA ESMERALDA GAYTAN ” Practice Location

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